EHR expert slams UK govt health programme

A damning report has been released in the UK by an expert in electronic health records who participated in last year’s Health Informatics New Zealand conference.

The report looks into that country’s attempt to establish National Health Service (NHS) summary care records (SCR), claiming the project has delivered only modest benefits after billions of pounds have been spent creating them.

The report by Professor Trisha Greenhalgh and a range of academic health experts at University College London, painted a picture of a stormy culture clash and heated meetings between clinicians, politicians, civil servants and IT integrators that is constantly tripping up progress on the £12.7 billion NHS National Programme for IT. Care records are one of the main parts of the programme.

Greenhalgh participated via video conference in last year’s Health Informatics New Zealand seminar in Auckland, which was held to stimulate debate about developing a national electronics health records strategy for this country. She is a world authority on shared electronic health records.

According to Computerworld UK, the report says rather than improving patient safety, a goal long-trumpeted by the government for the programme, patient records served so far only to reduce stress for clinicians.

As of a year ago, some £789 million had been spent on contractor costs to develop the spine, or database, according to a parliamentary written answer in 2009. This did not include the £1.4 billion also spent so far on supplier costs to develop hospital patient administration systems or GP costs to extract and clean the data.

Widely-voiced concerns, that doctors had been somewhat ignored when the programme was created, were also addressed by the new report. The report quoted staff at BT, the supplier delivering the SCR database, who said they felt the original specification “had been set in board-level meetings where insufficient attention had been paid to the perspective of front-line users”.

A previous version of the report criticised the automatic opt-in of patients to the scheme, which it said was questionable on legal grounds as many people did not understand what they were being signed up to. The NHS for the most part did not address the concerns, sticking with the opt-in model and making only the concession of insisting doctors ask patients’ consent to view the SCR.

Doctors have also expressed concerns about “mission creep”, whereby the possibility that data is added to the records over time but patients not understanding that the sensitive information would be added. The newly-released University College London report noted that staff in a range of settings had different attitudes to the need for consent to upload this information.

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